1. 1 Comments on proposed Medicaid and CHIP funding in SB 1 and HHSC Exceptional Items House Committee on Appropriations, Subcommittee on Health and Human Services Austin, Texas February 11, 2005 Anne Dunkelberg, Assistant Director (dunkelberg@cppp.org) 900 Lydia Street - Austin, Texas 78702 Phone (512) 320-0222 – fax (512) 320-0227 - www.cppp.org

2. 2 CPPP supports funding for: Medicaid current services: Exceptional items 1,2,14, and 17. Reversing Medicaid Cuts made in 2003: –In particular, Exceptional items 15 and 16, Restore Adult Benefits and Partially Restore Medically Needy –Exceptional item #3, Restore Provider rates CHIP Current Services: Exceptional items 8 and 9, caseload growth and cost growth. Reversing CHIP Cuts made in 2003 – In particular, Exceptional item 10, rate restoration. –Restore CHIP CBO Outreach and marketing to 2002-03 levels. Waiting Lists: Exceptional item #26

3. 3 Eliminated these services for ALL ADULTS on Medicaid: (Aged, Disabled, and Adult TANF recipients) mental health services by social workers, psychologists, licensed professional counselors, and licensed marriage and family therapists, podiatrists, eyeglasses and hearing aids chiropractors. WHO THEY ARE: Adults Losing Mental Health Services, Eyeglasses, Hearing Aids, Podiatry: All 862,500 of the 2.7 million Texans on Medicaid in January. 77% are elderly or disabled, all adult Texans on SSI (60%, who live on less than $580 per month), and all long-term/community care clients, including: –Most adult Texans with significant mental retardation; –Most Texans with serious mental illness that began before or in early adulthood; –Most Texans in nursing homes (about 70% of all Texans in nursing homes); and –Many Texans with major disabilities acquired before or in early adulthood, or lifetime disabilities

4. 4 Medically Needy Spend-Down Program for Parents (Temporary Coverage for Families with High Medical Bills): Provided Medicaid benefits on a month-to-month basis to parents of dependent children who had large medical bills that, when subtracted from earnings, reduced their income to 22%-31% of poverty ($395/month for a working parent with 2 children, or $275/month for a non-working parent of 2). Medically Needy spend-down still available for maternity coverage and persons under age 19, due to federal requirements. HHSC estimated about 10,000 fewer parents per month have been covered. Emergency Medicaid. Eliminating “spend-down” to “Emergency Medicaid” also cut payments to hospitals for emergency care provided to Legal AND undocumented immigrant parents. WHO THEY ARE: Medically Needy: Average age of parent was 34 years. Could not have income (after medical bills) of more than $395/month for family of 3, and no more than $2,000 in resources (liquid and certain vehicle values).